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Biopsy Of The Roof Of The Mouth

Ohio rates for HCPCS 42100

Takes a small piece of tissue from the roof of the mouth or from the uvula, the flap hanging at the back of the throat, so it can be examined under a microscope. Only a sample is taken and the rest of the area is left in place. It is done to find out what is behind a patch, sore, swelling or growth that has not settled on its own.

Rates data updated July 2026.

Facilitymedian $2,630 · 10th–90th $178$9,7720%10%10th90th$2,630Professionalmedian $141 · 10th–90th $102$2290%20%10th90th$141$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$2,630.27
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$141.25
Typical High
$223.87
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$144.54
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,691.53
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$134.90
Typical High
$218.78
CareSource
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$114.82
Typical High
$134.90
CareSource
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$323.59
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$363.08
Typical High
$575.44
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$323.59
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$72.44
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$2,398.83
Typical High
$2,398.83
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$154.88
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$2,137.96
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$144.54
Typical High
$239.88